State Facts About Title X and Family Planning: Hawaii

National Background and Context

Title X of the Public Health Service Act is the sole federal program devoted entirely
to family planning. Through Title X the federal government sets family planning policy,
and its flexible grant funds not only subsidize direct client services, but are critical
to putting family planning centers in communities and to supporting their ongoing
infrastructure needs.

These services are vital: U.S. women who are not using contraceptives, or who are using
them inconsistently, represent one-third of all women at risk of unintended pregnancy and
account for 95% of the three million unintended pregnancies that occur every year.(1) Unintended pregnancy, in turn, has been linked with numerous
negative maternal and child health outcomes. More broadly, women’s ability to rely on
contraception enables them to invest in higher education and to be full participants in
the nation’s workforce.(2,3)

Title X is central to helping women meet their reproductive health goals. In 2012, an
estimated 6.1 million female contraceptive clients were served at publicly funded family
planning centers, 71% of whom—4.3 million women—were served at sites supported by Title X.(4) Contraceptive services at Title X–supported family
planning centers helped women and couples avoid 1.1 million unintended pregnancies, which
would likely have resulted in 526,900 unplanned births and 362,500 abortions (the remainder would have resulted in miscarriages).(4) Without these services, unintended pregnancy, unplanned birth and abortion in the United
States would be 32% higher.(4) And by helping women avoid
unintended pregnancies, Title X–supported centers saved taxpayers $5.3 billion in 2010,
amounting to $5.68 saved for every $1 spent providing contraceptive care.(5)

One-quarter of all poor women who obtain contraceptive services each year do so at a
site that receives Title X funding.(6) Among women overall, 10%
obtain a Pap test or pelvic exam at a Title X–supported site, as do 18% obtaining services
for a sexually transmitted infection.(6) It is therefore not at
all surprising that six in 10 women who obtain care at a Title X–supported center consider
it to be their usual source of medical care.(6)

The Need for Title X in Hawaii

•In 2012, 70,970 women in Hawaii were in need of publicly supported contraceptive
services and supplies.(4) Such women are sexually active; aged
13–44; able to become pregnant and not pregnant, postpartum nor trying to become pregnant;
and either have a family income below 250% of the federal poverty level or are younger
than age 20.

•In Hawaii, 12% of women in need of publicly supported contraceptive services and
supplies are uninsured, compared with 30% nationally.(4) Title
X–supported family planning centers play an especially important role in serving the
uninsured, who often cannot afford to pay out-of-pocket at private health care providers.

•In the absence of these services, the number of unintended pregnancies in Hawaii
would be 18% higher, and the number of abortions would be 24% higher. The number of teen pregnancies in Hawaii would be 34% higher.(12)

•By helping women avoid unintended pregnancies and the births that would follow, the
services provided at Title X– supported centers in Hawaii saved $43.6 million in public funds
in 2010.(5)

8. Sonfield A and Kost K, Public Costs from Unintended Pregnancies and the Role of
Public Insurance Programs in Paying for Pregnancy and Infant Care: Estimates for 2008, New
York: Guttmacher Institute, 2013,
<http://www.guttmacher.org/pubs/public-costs-of-UP.pdf>,accessed October 22, 2013.